Is surgery good for adrenal pheochromocytoma?

Surgical treatment of adrenal pheochromocytoma is the most effective method, but patients need to understand that this surgical treatment has certain risks. During the operation, the tumor may be squeezed, causing blood pressure fluctuations or causing heavy bleeding.

1. Surgical removal of pheochromocytoma is the most effective treatment, but surgery has certain risks. The compression of the tumor during anesthesia and surgery can easily cause blood pressure fluctuations; tumors are richly supplied with blood and are close to large blood vessels, which can easily cause massive bleeding. Therefore, correct management before, during and after surgery is extremely important. In patients with pheochromocytoma, due to the higher secretion of catecholamines, their blood vessels are in a state of contraction for a long time. Although their blood pressure is high, their blood volume is often insufficient. Therefore, sufficient medication should be prepared before surgery to achieve the purpose of dilating blood vessels, lowering blood pressure, and expanding blood volume.

2. Currently, α-adrenergic receptor blocker phenoybenzamine is used in a variety of ways, with a dose of 10-20 mg, 2-3 times a day, for 2-6 weeks. β-adrenergic receptor blocker propranolol 10 mg, 2 to 3 times a day, for about 1 week before surgery can prevent tachycardia and arrhythmia during surgery.

3. The selection of anesthesia methods and anesthetic drugs should meet the following conditions: ① There should be no obvious inhibitory effect on cardiac pump efficiency; ② It should not increase sympathetic excitability; ③ It is beneficial to control blood pressure during surgery; ④ After tumor resection, it is beneficial to restore blood volume and maintain blood pressure. At present, general anesthesia is still advocated. The surgical incision can be determined based on the accuracy of the diagnosis and positioning as well as the size of the tumor. In most cases, an abdominal exploratory incision is more appropriate for diagnosis. Pre-placement of a floating catheter (Swan-Ganz cardiac catheter) before surgery to monitor pulmonary artery wedge pressure can accurately and reliably monitor the patient's heart pumping condition and effectively maintain blood volume, providing favorable conditions for ensuring the smooth completion of the operation. α-Methyltyrosine has the effect of blocking the synthesis of catecholamines. It can be used in combination with benzylamine in patients who cannot undergo surgery, but long-term use can easily lead to drug resistance.